ABSTRACT
@#Branchial apparatus anomalies usually manifest in teenage or early adult life. Infection complicates second branchial pouch anomalies usually presented as a neck lump or discharging sinus. It is the most common form of anomalies compared to another branchial pouch aberrant. However, it is extremely rare to find a complete branchial fistula with both internal and external openings. Misdiagnosis usually occurs leading to inappropriate and suboptimal treatment. Here, we report of a case of complete second branchial pouch fistula and discuss the clinical presentation and surgical management of such lesion.
ABSTRACT
Introduction: Branchial fistulas and cysts, involving soft tissues of the neck, are quite uncommon anomalies of embryonic development that are commonly encountered by pediatric surgeons. Approximately 17% of all cervical masses in the pediatric age group are due to branchial anomalies. Although branchial cleft cysts are usually benign, infection, discharge, mass effect, and other surgical complications account for its morbidity. Aim: To assess 10 rare cases of a complete second branchial fistula which were diagnosed and treated in last 5 years by single neck incision in the Department of Surgery S. N. Medical College, Agra. Material and Methods: 10 cases of complete second branchial fistula were reported and managed in our institute. The age group of patients was from 2 to 12 months of age. These patients presented with an intermittent serous and mucoid discharge from an external opening in the lower aspect of the neck since birth. Most of the patients presented with opening on the right side of the neck. A pre-operative fistula gram done in all cases revealed the internal opening of tracts up to the peritonsillar fossa. In all cases, complete excision of the tracts was done by single step neck incision. Results: All the 10 patients underwent surgery with satisfactory results. Regular follow-up was done at biweekly for 1 month followed by monthly intervals up to 12 months. None developed any complications and no patient had recurrence. Conclusion: Although second branchial fistulae are common, complete fistulae with internal opening up to tonsillar fossa are rare, single step management of these cases merits the publication of this series. The report also guides on the need to perform a pre-operative fistulogram for the management of these cases.
ABSTRACT
Branchio-oto-renal (BOR) syndrome is a rare congenital anomaly that is characterized by preauricular pits, branchial fistula and hearing impairment and it is often combined with renal anomalies. BOR syndrome is inherited in an autosomal dominant mode and the mutations of two genes, EYA1 and SIX1, have been identified. We experienced a case of a 14-year-old female who complained of bilateral neck openings and hearing loss that were found at birth the girl's family had a familial tendency for these features. A skin biopsy from the cervical lesion showed the characteristic features of branchial fistula. We report here on a case of BOR syndrome and we review the relevant literature.
Subject(s)
Adolescent , Female , Humans , Biopsy , Branchio-Oto-Renal Syndrome , Fistula , Hearing Loss , Neck , Parturition , SkinABSTRACT
Objective: To discuss how to improve the level of diagnosis and treatment about the firstbranchial fistula. Method:16 cases with the first branchial fistula were analyzed retrospectively. Result :Of all thepatients underwent surgery, 14 cases were free from disease postoperatively within 0.5 years follow-up, 2patients underwent re-operation because of recurrence. Conclusion:Knowing about the disease fully, selectingproper surgical incision and possessing skilled surgical technique is important to improve the level of diagnosisand treatment about the first branchial fistula.
ABSTRACT
Melnick-Fraser syndrome is a rare congenital anomaly that is characterized by preauricular fistula, branchial fistula, hearing impairment, and is often combined with renal anomaly. Preauricular fistula and branchial fistula can occur in the same individual, but their association with hearing impairment is very rare. The condition is inherited in an autosomal dominant mode. Recently, we experienced a case of Melnick-Fraser syndrome in a 32 years old male patient with familial tendency. We report this case with a review of literature.